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"Azathoth" is the name given in the Necronomicon to "the monstrous nuclear chaos beyond angled space," the illusory personification of the Big Bang, just as "Thor" personifies lightning. The "invocation" or "summoning" of "Azathoth" is occult code for the release of atomic energy.

It's written by Kenneth Hite, using the principles of Syncretism and Bissociation. Hite brings his own personal style to the work. He incorporates scientific principles, occult musings, and bizarre trivia into every page, such as in the quote about Azathoth, above. Best of all, he points out where the source material contradicts itself, rather than enforcing a particular definition. He encourages you to decide which of many interpretations are correct, including the possibilities of all (or none) of them.

It uses the GUMSHOE system, which features guaranteed competence for clue-gathering actions. This structures the adventures more like an episode of CSI (or NCIS or Law & Order or Etc) where the clues are certain to catch the investigator's attention. As opposed to original flavor CoC, where one bad die roll can deny you the vital clue that you needed to save the Earth. Don't worry, characters are still fragile, and you can still screw up, fail miserably, or go insane - it just won't be the result of some arbitrary die roll.

In tone, actual play of Trail of Cthulhu is very similar to Call of Cthulhu, though with slightly more emphasis on the police procedural and forensics elements. Mechanics involve more resource-management, and less randomness. Also, some mechanics and elements in the game are designated as Purist or Pulp, clearly marked so that the GM can chose to use only those that reinforce the subtype of Cthulhu tale they are trying to tell.

As noted in regards to Azathoth and Hite, many of the creatures and Great Old Ones are given some new correspondences and explanations in Trail. While a Fourth-Dimensional Lifeform would never seem out-of-place in Call, it seems even more appropriate in Trail. They aren't just monsters, they are dynamic other-worldly forces of unnature. In standard COC, "monstrous nuclear chaos" is just a poetic metaphor to describe Azathoth, in Trail, it might be anything from literal truth to magically figurative.

That said, the tropes common to Cthulhu Mythos and Cosmic Horror are all at home in Trail of Cthulhu, though perhaps they come peppered with a little bit more theoretical physics than you might otherwise expect.

Sources

Game and Story Use

Tons of cool ideas in this RPG to be stolen for your own game.

Robin Laws mechanics can be easily ported to another setting to enhance mystery plotlines.

Kenneth Hite's insights into the Cthulhu Mythos are unique and exciting, and keep it from ever feeling like an Eldritch Abomination is "just another monster". Most monster entries in the book include several possible clues the GM could drop about the physical nature of the beast in question, and what kind of disruption it leaves in it's wake. It's a lot more visceral than a brief description followed by a block of combat stats.